Prognostic Relevance of Pulmonary Arterial Compliance in Patients With Chronic Heart Failure

Puppa, Paolo; Rossi, Andrea; Pasotti, Michele; Raineri, Claudia; Cicoira, Mariantonietta; Bonapace, Stefano; Dini, Frank Lloyd; Temporelli, Pier Luigi; Vassanelli, Corrado; Vanderpool, Rebecca; Naeije, Robert; Ghio, Stefano

doi:10.1378/chest.13-1510

Cited by 134 publications

(114 citation statements)

References 21 publications

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“…These correlations may contribute to the predictive ability of PAC for poor outcomes in HF patients, as seen in previous reports on RHC-PAC. 10,11, 27 The present study expands those results and shows that PAC obtained noninvasively with Doppler echocardiography is also useful for identifying this subgroup of advanced HF patients at high risk for worse outcomes, who may be potential candidates for LVAD.…”

Section: Discussionsupporting

confidence: 71%

“…Our results from comparing them with RHC-PAC values found that the echocardiographic values tended to be higher in the upper range when measured in patients without PH who had preserved values of RHC-PAC (4.5±2.1 mL/mmHg), 27 whereas the difference in the lower range was small. There was no significant difference between SV by echocardiography and catheterization (mean difference: −1.7 mL, P=0.14).…”

Section: Discussionmentioning

confidence: 57%

“…Patients with pulmonary arterial hypertension have greatly elevated PVR, and PVR is therefore an important index in clinical practice. On the other hand, in HF patients, even in advanced HF, greatly elevated PVR is not common, 27 suggesting that detecting patients with low PAC or modestly elevated PVR may be adequate for performing risk stratification. Therapy for advanced HF is changing in the current era because of improvements in LVAD therapy.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Significance of Pulmonary Arterial Capacitance Calculated by Echocardiography in Patients With Advanced Heart Failure

Saito

Ohtani

Kioka

et al. 2017

Circ J

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Significance of Pulmonary Arterial Capacitance Calculated by Echocardiography in Patients With Advanced Heart Failure

Saito

Ohtani

Kioka

et al. 2017

Circ J

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“…A constant RC-time product has important implications for the assessment of RV afterload, namely that PVR and total arterial compliance are redundant measurements and knowledge of one enables the derivation of the other. Exceptions to the constant RC-time product have recently been documented, for example in PH-related to left heart disease [22][23][24][25], prompting a re-evaluation of the concept of RC-time constancy [26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

et al. 2015

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Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent studies have popularised the concept that their product (RC-time of the pulmonary circulation, in seconds) is "constant" in health and diseases. However, emerging evidence suggests that this concept should be challenged, with shortened RC-times documented in post-capillary PH and normotensive subjects. Furthermore, reported RC-times in the literature have consistently demonstrated significant scatter around the mean. In precapillary PH, the true PVR can be overestimated if one uses the standard PVR equation because the zero-flow pressure may be significantly higher than pulmonary arterial wedge pressure. Furthermore, SV/PApp may also overestimate true C. Further studies are needed to clarify some of the inconsistencies of pulmonary RC-time, as this has major implications for our understanding of the arterial load in diseases of the pulmonary circulation. @ERSpublications Empiric estimates of pulmonary arterial load are prone to errors and may result in overestimation of RC-time

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“…Haemodynamic parameters measured at right heart catheterisation (RHC), such as mean right atrial pressure and pulmonary arterial compliance, have proved to be reliable predictors of outcomes in several clinical settings including pulmonary arterial hypertension and chronic heart failure 1,2 . Severe aortic valve stenosis (AS) produces significant changes in the interdependent left and right ventricular haemodynamics 3 .…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation

Franzone¹,

O’Sullivan²,

Stortecky³

et al. 2017

EuroIntervention

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Aims: The aim of the study was to evaluate the prognostic utility of right heart catheterisation (RHC)-derived measures among patients undergoing transcatheter aortic valve implantation (TAVI). and December 2012 and undergoing preoperative RHC were analysed. The relationship between haemodynamic parameters and survival was evaluated with Cox proportional hazards models. At two-year follow-up, 118 patients had died (25.1%). At multivariable analysis, diabetes (hazard ratio [HR] 1.95, 95% confidence interval [CI]: 1.28-2.96, p=0.001), transapical access (HR 1.66, 95% CI: 1.07-2.56, p=0.02), and moderate or severe mitral regurgitation (HR 1.55, 95% CI: 1.00-2.39, p=0.04) were independent predictors of two-year mortality, whereas no correlation between RHC-derived measures and mortality was found. Furthermore, the addition of haemodynamic variables did not significantly improve the prognostic power of a model incorporating clinical and echocardiographic data p=0.47). Methods and results:Conclusions: On the basis of a comprehensive clinical and echocardiographic evaluation, RHC performed prior to TAVI does not add incremental prognostic value. KEYWORDS• aortic stenosis • risk stratification • transcatheter aortic valve implantation (TAVI)

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Prognostic Relevance of Pulmonary Arterial Compliance in Patients With Chronic Heart Failure

Cited by 134 publications

References 21 publications

Clinical Significance of Pulmonary Arterial Capacitance Calculated by Echocardiography in Patients With Advanced Heart Failure

Clinical Significance of Pulmonary Arterial Capacitance Calculated by Echocardiography in Patients With Advanced Heart Failure

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation

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